Hair today - gone tomorrow (no, not Robin's hair yet)

Robin started the day by looking peppy for about 30 minutes. Then she ate a few spoonfuls of yogurt and she has been wiped out ever since. At first it looked like we would have a day of hanging out and chatting. But so far she's just laid still in bed looking drowsy.

Today the nurse reviewed how to give liquid food through the PEG. She mentioned that each day we should put through at least one 8oz can, and eventually Robin will get five cans a day. I asked if that was when radiation therapy starts and the nurse said "no" it could be very soon since (apparently) the side effects of the chemo are not just going to occur during the four days of treatment here in New York City, the side effects will continue to mount over time. I guess reality is starting to set in. Although Robin had read stories of people getting chemo and going back to work, she may or may not have that type of experience. I now think back to the Monday meeting with the oncologist who said Robin is going to get a comparatively heavy dose of chemo. The good news is that the tumor in her cheek and gums is already showing signs of shrinking a little - for that we are happy!

The chemo medications are designed to damage cancer cells as they grow and divide. The medications have the most impact on rapidly growing cells, unfortunately they also attack normal rapidly growing cells in your body. The most common normal cells affected are blood cells which grow in bone marrow (so your white cell count drops and you become prone to infection), cells lining the digestive system (so you may have trouble eating) and hair follicles (that's why hair is prone to fall out!). Whether Robin will get three chemo treatments partly depends how much havoc the first two treatments have on her. My sense is that the more chemo courses Robin completes, the more cancer it will kill (but that's an assumption on my part...). If the first course really devastates her body's good cells, then they will only plan to complete two courses. That's why they can't tell us what will happen next until they test her blood in a couple of weeks.